Basic Pharmacology For Nurses by Clayton Stock Harroun

[missjennmb]

I need help. I have been through the same chapter 50 times and I just get more and more and MORE lost each time. Has anyone used this book for Pharmacology that could tell me how to understand what I am reading and pick out the key differences between the meds?

I see things that should be labeled as postprandial diabetes meds listed without that as a therapeutic outcome (while others have it listed) and a dozen drug classes with the same drug interactions except one or two differences and nothing bold printed/pointed out to suggest that one difference between them.

I am at my wits end and severely frustrated. I have ordered the "Clinical Pharmacology Made Incredibly Easy" book through the interlibrary loan, but not sure yet how long it will take to get it, and am going to get another one (and have "Pharmacology Demystified" already, but without understanding the book my teacher takes test questions from, I am completely at my wits end. There is SO much filler in the pages of this book that I am unable to figure out just what to put on a drug card, without it being a drug stack of cards, and when I do pick and chose what *I* think is most important, it ends up not being remotely what is on the test.

Someone please help me. I am so frustrated and so disgusted. The way that my class is, I have to learn a lot on my own, because so much is packed into our classes that we are not able to cover everything, and my teacher does not do reviews (her idea of a review for our last final was to tell us 3 pages front and back of subject - one subject per line - of things we should study...and that was only the things from one section of material, when our test was on 4 sections and this was 2 days before our final).

I have never ever in my life had a subject where I could not pick the book apart and learn the material before now. And I'm still trying to get a full grasp on the first chapter, when my test is on 10 chapters, with no class time allotted for review (meaning we will probably not be getting one so I am panicking even though the test is still a week and a half away)

[pagandeva2000, LPN]

I did not use that book for nursing school but purchased it on my own and found it a bit easier to understand, but from what you describe about your professor and remembering for format of the book, I can understand you point.

Maybe this will help...When you break up the medications, break them into classifications, and under the classifications, such as diabetes, you have several areas;

insulin-know the side effects, onset and peak times.

Oral Meds:

Sulfonylureas: first generation ones end with "mide" (eg Tolbutamide), second generation ones (which are more commonly used these days) are like glyberide, glipizide (end in 'ide'):

Main thing is that they cause hypoglycemia because they squeeze insulin from the pancreas. So, you may advise a patient to eat while taking these medications because their sugar may drop. Most are taken either 1/2 hour before or with meals. Worry about rashes with these, from what I remember.

Metformin (Glucophage) works on the liver by decreasing the amount of glucose production when it is not needed.

-no hypoglycemia

- must take with food to avoid gastric distress

- **must stop taking two or three days before using constrast dye studies (remember this)**

- used for fasting hyperglycemia

- lactic acid build up

Alpha Glucosidase Inhibitors: Acarbose (Precose) (most often used)

work by slowing glucose uptake after meals in the intestines, so, it must be taken at the first bite of the meal (I call it 'love at first bite').

- does not cause hypoglycemia

- main complaint is gastric distress

Glitazones: they end in "zones" such as rosglitazone. Works by increasing insulin sensitivity of the muscles, or decreasing insulin resistance.

- water retention

- improved fertility (advise birth control)

- take with or without food

- insulin sparing-meaning that the body does not have to use as much insulin to control glucose while taking this drug.

Pioglitazone (same catagory)

-can reduce estrogen levels which can make the Pill or DepoProvera less effective

Meglintinides: end in "glinide" such as Repaglinide/Nateglinide-also squeeze insulin from the pancreas, but they are taken just before meals to stimulate insulin production for that meal only, versus the Sulfonylureas, which work all day.

Hope this summary is a bit helpful!